Spontaneous breathing approach in mild congenital diaphragmatic hernia: a resuscitation algorithm
<strong>Background:</strong> Infants with a congenital diaphragmatic hernia (CDH) and expected mild pulmonary hypoplasia have an estimated survival rate of 90%. Current guidelines for delivery room management do not consider the individual patient's disease severity, but an individu...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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Frontiers Media
2022
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| _version_ | 1797107710733320192 |
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| author | Horn-Oudshoorn, EJJ Knol, R Cochius-den Otter, SCM Te Pas, AB Hooper, SB Roberts, CT Rafat, N Schaible, T de Boode, WP van der Lee, R Debeer, A Kipfmueller, F Roehr, CC Reiss, IKM DeKoninck, PLJ |
| author_facet | Horn-Oudshoorn, EJJ Knol, R Cochius-den Otter, SCM Te Pas, AB Hooper, SB Roberts, CT Rafat, N Schaible, T de Boode, WP van der Lee, R Debeer, A Kipfmueller, F Roehr, CC Reiss, IKM DeKoninck, PLJ |
| author_sort | Horn-Oudshoorn, EJJ |
| collection | OXFORD |
| description | <strong>Background:</strong> Infants with a congenital diaphragmatic hernia (CDH) and expected mild pulmonary hypoplasia have an estimated survival rate of 90%. Current guidelines for delivery room management do not consider the individual patient's disease severity, but an individualized approach with spontaneous breathing instead of routine mechanical ventilation could be beneficial for the mildest cases. We developed a resuscitation algorithm for this individualized approach serving two purposes: improving the success rate by structuring the approach and providing a guideline for other centers.
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Methods:</strong> An initial algorithm was discussed with all local stakeholders. Afterwards, the resulting algorithm was refined using input from international experts.
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Results:</strong> Eligible CDH infants: left-sided defect, observed to expected lung-to-head ratio ≥50%, gestational age at birth ≥37.0 weeks, and no major associated structural or genetic abnormalities. To facilitate fetal-to-neonatal transition, we propose to start stabilization with non-invasive respiratory support and to adjust this individually.
<br><strong>
Conclusions:</strong> Infants with mild CDH might benefit from an individualized approach for neonatal resuscitation. Herein, we present an algorithm that could serve as guidance for centers implementing this. |
| first_indexed | 2024-03-07T07:18:21Z |
| format | Journal article |
| id | oxford-uuid:682e4306-fed8-4650-83e5-9e1e3cb90420 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:18:21Z |
| publishDate | 2022 |
| publisher | Frontiers Media |
| record_format | dspace |
| spelling | oxford-uuid:682e4306-fed8-4650-83e5-9e1e3cb904202022-09-13T16:00:26ZSpontaneous breathing approach in mild congenital diaphragmatic hernia: a resuscitation algorithmJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:682e4306-fed8-4650-83e5-9e1e3cb90420EnglishSymplectic ElementsFrontiers Media2022Horn-Oudshoorn, EJJKnol, RCochius-den Otter, SCMTe Pas, ABHooper, SBRoberts, CTRafat, NSchaible, Tde Boode, WPvan der Lee, RDebeer, AKipfmueller, FRoehr, CCReiss, IKMDeKoninck, PLJ<strong>Background:</strong> Infants with a congenital diaphragmatic hernia (CDH) and expected mild pulmonary hypoplasia have an estimated survival rate of 90%. Current guidelines for delivery room management do not consider the individual patient's disease severity, but an individualized approach with spontaneous breathing instead of routine mechanical ventilation could be beneficial for the mildest cases. We developed a resuscitation algorithm for this individualized approach serving two purposes: improving the success rate by structuring the approach and providing a guideline for other centers. <br><strong> Methods:</strong> An initial algorithm was discussed with all local stakeholders. Afterwards, the resulting algorithm was refined using input from international experts. <br><strong> Results:</strong> Eligible CDH infants: left-sided defect, observed to expected lung-to-head ratio ≥50%, gestational age at birth ≥37.0 weeks, and no major associated structural or genetic abnormalities. To facilitate fetal-to-neonatal transition, we propose to start stabilization with non-invasive respiratory support and to adjust this individually. <br><strong> Conclusions:</strong> Infants with mild CDH might benefit from an individualized approach for neonatal resuscitation. Herein, we present an algorithm that could serve as guidance for centers implementing this. |
| spellingShingle | Horn-Oudshoorn, EJJ Knol, R Cochius-den Otter, SCM Te Pas, AB Hooper, SB Roberts, CT Rafat, N Schaible, T de Boode, WP van der Lee, R Debeer, A Kipfmueller, F Roehr, CC Reiss, IKM DeKoninck, PLJ Spontaneous breathing approach in mild congenital diaphragmatic hernia: a resuscitation algorithm |
| title | Spontaneous breathing approach in mild congenital diaphragmatic hernia: a resuscitation algorithm |
| title_full | Spontaneous breathing approach in mild congenital diaphragmatic hernia: a resuscitation algorithm |
| title_fullStr | Spontaneous breathing approach in mild congenital diaphragmatic hernia: a resuscitation algorithm |
| title_full_unstemmed | Spontaneous breathing approach in mild congenital diaphragmatic hernia: a resuscitation algorithm |
| title_short | Spontaneous breathing approach in mild congenital diaphragmatic hernia: a resuscitation algorithm |
| title_sort | spontaneous breathing approach in mild congenital diaphragmatic hernia a resuscitation algorithm |
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